Provider Demographics
NPI:1437577822
Name:UNION, MELISSA
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:UNION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:UNION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED, BCBA
Mailing Address - Street 1:400 N FIRST ST
Mailing Address - Street 2:APT 7D
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23664-1446
Mailing Address - Country:US
Mailing Address - Phone:407-230-0482
Mailing Address - Fax:
Practice Address - Street 1:400 N FIRST ST
Practice Address - Street 2:APT 7D
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23664-1446
Practice Address - Country:US
Practice Address - Phone:407-230-0482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst